Inflammation, Metalloproteinases, Chronic Venous Disease and Sulodexide

Munari, Alberto; Fern, Luis; Cervera, o Flota

doi:10.4172/2329-9517.1000203

Cited by 9 publications

(4 citation statements)

References 47 publications

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“…16,124–126 The above mentioned properties of sulodexide together with hemodynamic properties allow patients treated with sulodexide to have improved CVD symptoms and achieve healing of venous ulcers. 12,112,127–131 The meta-analysis of observational studies reported in this work (Supplementary Appendix 4, Figures 1 to 8), as already shown in previous studies, 15 confirmed the expected effectiveness of sulodexide in improving symptoms, signs and indirectly the quality of life of patients with CVD.…”

Section: Discussionsupporting

confidence: 85%

Systematic literature review and network Meta-analysis of sulodexide and other drugs in chronic venous disease

et al. 2021

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Objective To assess the clinical efficacy of sulodexide, including a comparison with venoactive drugs (VAD) (micronized purified flavonoid fraction, MPFF; hydroxy-ethyl-rutosides, HR; calcium dobesilate;Ruscus extract combined with hesperidin methyl chalcone and vitamin C, Ruscus+HMC+VitC; horse chestnut seed extract, HCSE) and pentoxifylline in patients with chronic venous disease. Methods We performed a literature search in MEDLINE, Embase, and Cochrane Library for randomized controlled trials (RCTs) and observational studies. Proportion of patients with complete venous ulcer healing was the primary outcome and lower leg volume, foot volume, ankle circumference and symptoms were the secondary outcomes. Bayesian network meta-analysis (NMA) was perfomed with random effects models using only RCTs. A meta-analysis of observational studies was performed for sulodexide because no RCT could be included in NMA for symptoms or signs. Results Forty-five RCTs and eighteen observational studies were identified. Sulodexide was included only in a single NMA for the proportion of patients with complete ulcer healing and it showed to have the highest probability of being the best treatment (48%) compared with pentoxifylline (37%) and MPFF (16%). MPFF was the most effective treatment in reducing lower leg volume, CIVIQ-20 score and pain VAS scale while calcium dobesilate and Ruscus+HMC+VitC were the most effective in reducing foot volume and ankle circumference respectively. Meta-analyses of observational studies for sulodexide showed that it improves significantly the scoring of pain, feeling of swelling, heaviness and parasthesiae measured by Likert scales. Conclusions Sulodexide is at least as effective as pentoxifylline and more effective than MPFF in improving the rate of ulcer healing in patients with CVD. VADs are effective in improving venous symptoms and signs, as was also shown by sulodexide in the meta-analysis of observational studies. The relative effectiveness of sulodexide and VADs needs to be evaluated by an RCT in order to better inform clinical practice.

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Section: Discussionsupporting

confidence: 85%

Systematic literature review and network Meta-analysis of sulodexide and other drugs in chronic venous disease

et al. 2021

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“…It is interesting, because inflammation was found to be up‐regulated in VVs, and endothelium of VVs patients was shown to produce increased levels of such molecules . As a consequence, leukocyte “trapping” can occur leading to the release of superoxide anions, growth factors, chemoattractant molecules, and proteases with subsequent disruption of vein wall structure and loss of venous tone . The final event can be development of venous ulcers.…”

Section: Discussionmentioning

confidence: 99%

“…Several GWA studies performed on European and Asian populations revealed the association of the CASZ1 gene polymorphism with high blood pressure and arterial hypertension . Notably, venous hypertension is considered to be one of the key factors underlying pathological venous wall remodeling seen in VVs, in particular by inducing hypoxia and vascular damage . Although early stages of VVs are not characterized by venous hypertension, all veins are exposed to physiological filling pressure changes.…”

Section: Discussionmentioning

confidence: 99%

Polymorphisms of genes involved in inflammation and blood vessel development influence the risk of varicose veins

et al. 2018

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Heredity plays an important role in the etiology of varicose veins (VVs). However, the genetic basis underlying this condition remains poorly understood. Our aim was to replicate top association signals from genome-wide association studies (GWASs) for VVs of lower extremities using 2 independent datasets-our sample of ethnic Russian individuals (709 cases and 278 controls) and a large cohort of British residents from UK Biobank (10 861 cases and 397 594 controls). Associations of polymorphisms rs11121615, rs6712038, rs507666, rs966562, rs7111987, rs6062618, and rs6905288 were validated in the UK Biobank individuals at a Bonferroni-corrected significance level. In Russian cohort, only rs11121615 reached a nominal significance level of P < .05. Results of original GWAS and replication studies were combined by a meta-analysis, and polymorphisms listed above as well as rs111434909 and rs4463578 passed a genome-wide significant threshold. Notably, the majority of these polymorphisms were located within or near genes involved in vascular development and remodeling, and regulation of inflammatory response. Our results confirm the role of these polymorphisms in genetic susceptibility to VVs and indicate the revealed genomic regions as good candidates for further fine-mapping studies and functional analysis. Moreover, our findings implicate inflammation and abnormal vascular architecture in VVs pathogenesis.

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“…По данным, собранным в обзоре Munari et al [106], воздействие сулодексида на патогенез ХЗВ реализуется одновременно в нескольких следующих направлениях [107][108][109][110][111][112][113].…”

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2020

Наук.Вісн.Уж.Унів.Сер.Мед

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Свідоцтво про державну реєстрацію друкованого засобу масової інформації №7972, серія КВ від 9.10.2003 року, видане Державним комітетом телебачення і радіомовлення України У 2016 році Міжнародний Центр періодичних видань (ISSN International Centre, Париж) включив фаховий збірник наукових праць «Науковий вісник Ужгородського університету», серія «Медицина» до міжнародного реєстру періодичних засобів масової інформації і надав йому числовий код міжнародної ідентифікації:

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Inflammation, Metalloproteinases, Chronic Venous Disease and Sulodexide

Cited by 9 publications

References 47 publications

Systematic literature review and network Meta-analysis of sulodexide and other drugs in chronic venous disease

Systematic literature review and network Meta-analysis of sulodexide and other drugs in chronic venous disease

Polymorphisms of genes involved in inflammation and blood vessel development influence the risk of varicose veins

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